Shannon M Talatzko, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11732-024 Issued in WI

Practice address

146 E Geneva SQ
East Side BLDG
Lake Geneva, WI 53147-9694

Phone

(414) 647-6280

NPI assigned

Aug 3, 2011

Last updated

Feb 11, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Shannon M Bartel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1528346897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W165S7431 BELLVIEW DR",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508840",
            "telephone_number": "414-412-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 E GENEVA SQ",
            "address_2": "EAST SIDE BLDG",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531479694",
            "telephone_number": "414-647-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALATZKO",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11732-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BARTEL",
            "middle_name": "M",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.